an open-source thought experiment in psychedelic law and policy

"Medical marijuana" programs have few patients – and why is that?

The press release is the summary of a study authored by researchers at Columbia University:

Variation in medical marijuana program regulations impacts enrollment: A study published today in Health Affairs found that while 14 of the nation’s 24 medical marijuana programs were essentially nonmedical in practice, they enrolled more than 99 percent of overall participants. Fewer than one percent were enrolled in ‘medicalized’ programs that adhere to accepted professional standards in medicine. The study analyzed the extent to which medical marijuana laws and program regulations incorporate accepted medical practice, good pharmaceutical manufacturing practices as established by the FDA, and restrictions on controlled substances.

They conclude that the very low number of patients enrolled in states with “medicalized” programs means only that there are high numbers of “recreational” users who are ‘gaming’ the system [my term] in the states with “non-medicalized” programs:

“The extent to which states regulate their medical marijuana programs appears to have a striking impact on how many people actually use each program,” noted Mark Olfson, MD, professor of psychiatry at Columbia University Medical Center (CUMC) and senior author of the paper. “High enrollment rates in less regulated medical marijuana programs raise the possibility that these programs may inadvertently attract recreational users.”

“The new findings raise questions of why doctors are involved in non-medical programs in the first place,” added lead author Arthur Robin Williams, MD, MBE, a fellow in the Department of Psychiatry at CUMC. “Building on this study we will look for associations between more restrictive regulations and public safety – including rates of recreational marijuana use, diversion to adolescents, emergency department visits and drug treatment admissions.”

Based on the experience of New York, I will propose another hypothesis, which is that the unduly onerous “medicalized” programs are a cruel perversion of the original idea of state laws that were intended to facilitate access to cannabis by patients; instead the medicalized programs are intended to be or are operated as a means to deny access.